Metal Fillings, Mercury, and More

written by samantha tillapaugh from the debtist

Metal Fillings, Mercury, and More

Metal fillings sound like such an archaic topic, but it really wasn’t that long ago that we stopped using them in dentistry! I would wager that you either had them placed on a tooth at some point, or at least know someone who does. It’s even possible that you still have some metal fillings in your mouth! However, it’s time we talk about what metal fillings are, and why we should reconsider them.

Public concern about silver dental fillings has been present and rising since it was officially announced that metal mercury is toxic to the human body. Although silver fillings are not entirely made of mercury, they do contain mercury in them. Silver fillings are technically a mix of liquid elemental mercury, and powdered alloys that include silver, tin, and copper.  

For many years, the dental association has been saying that metal fillings are safe, until FINALLY, at the end of 2020, the ADA released a statement saying that metal mercury is unsafe for certain populations. My question is, why not for all populations? 

Of course, everyone has different views on holistic medicine, but regardless of where you stand, here are a few things to know about mercury and metal fillings.

Is mercury harmful?

Elemental (metallic) mercury is liquid at room temperature. Exposure to metallic mercury most often occurs when the metallic mercury is spilled or when products that contain metallic mercury break, making mercury exposed to air. When elemental mercury binds with air particles, it turns into methylmercury, which is very toxic to the human body. 

When inhaled as a vapor, metallic mercury is absorbed through the lungs and may cause negative health effects. Symptoms of prolonged and/or acute exposures include:

  • Tremors
  • Emotional changes (mood swings, irritability, nervousness, excessive shyness)
  • Insomnia
  • Neuromuscular changes (such as weakness, muscle atrophy, twitching)
  • Headaches
  • Disturbances in sensation
  • Changes in nerve response
  • Poor performance on tests of mental function

So how do we know that these health effects are present and caused by silver fillings.

Let dentists be proof.

We don’t know for sure, of course. The adage correlation does not mean causation is true. However, let dentists be proof. For many years, people have pondered as to why the suicidal rates of dentists are high. We blame it on the stress of our work, but other jobs are stressful too. What do dentists do that other people don’t?

We remove silver fillings. And the symptoms described above can contribute to suicidal thoughts, can it not? A patient of mine once told me of his three high school buddies, all of whom became dentists. One of the dentists took their own life. He recounts seeing his friend’s personality change over time, and how at the funeral, his other two dentist friends were discussing how the mercury in the profession has really altered their friend’s mental health.


The Debtist Bogobrush


Why were we told silver fillings are alright?

Even when I was in dental school, we were taught that silver fillings are totally safe. I graduated in 2016, which was not that long ago. The ADA has been saying that silver fillings are completely fine to use, despite studies that show otherwise. Their reasoning was as follows: When silver fillings are packed into the tooth as a solid, they are not releasing mercury particles. However, do recall that elemental mercury becomes harmful when products that contain metallic mercury break and when those mercury particles combine with air particles forming methylmercury. Through this logic, the ADA concluded that keeping silver fillings in the mouth was completely fine. In fact, it would be more dangerous to remove silver fillings (since the act of doing so releases the mercury gases that were trapped in the solid form) than it is to keep them in our mouths.

The flaw behind the thinking

The flaw behind this reasoning is that, often times, these silver fillings do break. And people cannot feel them breaking. Most people do not catch fractured silver fillings unless the break is so large that the filling comes out of the tooth. But I can attest to the fact that many of my patients who have silver fillings have marginal breakdown or microfractures around the metal fill. 

Which begs the question, are we inhaling these gases all along?

We are constantly using our teeth to chew. We are occasionally grinding our teeth when stressed. Both mean we are putting pressure on our silver fillings. There has been an argument that these occlusal forces will cause flexing of the silver fillings or the tooth, which will result in microfractures that the eye cannot see. 

What to do?

If you currently have no silver fillings in your mouth, I suggest never placing one. White fillings made of composite resin is quite common these days and would be my material of choice. If a dental office only offers silver fillings, I would really recommend looking for another.

If you have existing silver fillings, you can either wait until it comes time to replace them or replace them right away, depending on where you stand on the holistic medicine spectrum. Eventually, silver fillings will break down, usually beginning at the margins. This may cause bacterial leakage in the future, which will then lead to tooth decay. A silver filling can also crack in the center, due to wear or heavy occlusal forces. Either way, the ideal time to replace them is when these first signs of wear take place. If you go see your dentist regularly, ask them to take an intraoral photograph of your silver filling so you can see for yourself how they are holding up.

When you do replace them, you can choose to see a general dentist or a person who is trained to remove silver fillings and has the equipment to do it in a safe manner. I find that many of my patients seek the latter. Choosing to seek the latter protects not only you, but your dentist too!


The Debtist Bogobrush

How are silver fillings removed?

Specially trained dentists will have the facilities necessary to remove the silver filling without exposing themselves or their patients to the toxic gases released during silver filling removal. The dentist will likely wear something that looks like a gas mask. Sometimes, they wear hazmat suits which seems silly, but it is true! There will be a large suction tube placed on the patient’s chest, pointed at the oral cavity. This obnoxiously large tube sucks up the surrounding air, which may contain mercury particles.

 A general dentist can remove silver fillings too using simple protective techniques at their disposal. One such technique is using a rubber dam to prevent inhalation of the mercury. The rubber dam is placed at the mouth opening and provides a layer of protection for the airway. A general dentist can also use a nitrous oxide mask and have the setting at 100% oxygen, with the patient breathing through the nose so that they inhale 100% oxygen instead of inhaling the surrounding air through the mouth. Lastly, high speed suctions must be placed right on top of the tooth, to suck out all the metal bits and pieces being removed from the tooth. 

A word of caution

Not everyone is affected by metal toxins equally. Some people are more sensitive to metal toxicity, requiring only a small dose to experience health side effects. For the hypersensitive, mercury fillings can lead to developmental delays in children and trigger autoimmune diseases in adults. It is important to be cautious if you are of this population. I would 100% recommend removing your silver fillings while seeing a specialist if you are hypersensitive. I would also advise not to remove them all at once. Lastly, it might be beneficial to prepare for your appointment by taking nutritional supplements that will support your immune system during the removal process of your silver fillings. 

If you want to learn more about metal toxicity and health, I recommend this podcast with Dr. Mark Hyman. It’s a good one!

The Debtist Bogobrush

we’ve partnered with samantha tillapaugh, a general dentist practicing in southern california, to help spread the word about all cool things dental. when she isn’t sharing informative posts about teeth with us, she is writing at her own lifestyle blog as thedebtist. aside from writing, she travels the world, reads plenty of books sidled up next to her adopted, toothless cat, bakes sourdough bread and works as a tooth-fairy.